Initiated in 2009, the Colorectal Research Program was developed with three main areas of focus:
Colorectal Cancer Risk
Colorectal cancer is the third most common malignancy among both men and women in the United States and represents the second leading cause of cancer death. In addition to known genetic syndromes that increase risk of cancer, there are a variety of risk factors in the general population for developing colorectal cancer. These risk factors include consumption of red meat and especially processed meats, obesity, and a sedentary lifestyle.
The molecular pathways that transform a benign colorectal polyp into cancer may include genetic mutations and epigenetic phenomena that turn genes on and off. The colorectal cancer research program at HMRI currently focuses on the role of increased body mass index on epigenetic changes that occur in the colon.
Pelvic Floor Disorders
By age 50, one half of women will develop clinical problems related to pelvic floor relaxation. While not life-threatening, these disorders which include incontinence, obstruction, pelvic organ prolapse, and pain have a significant impact on quality of life. These problems can cause progressive dysfunction, and by age 80, 11% of women in the United States will undergo surgery for incontinence or pelvic organ prolapse.
Our research program seeks to understand age-related changes in the pelvic floor with aging and obesity utilizing state-of-the-art MRI technology. Moreover, Dr. Kaufman was one of 16 international investigators who studied the effect of sacral nerve stimulation on bowel control. This therapy was recently approved by the FDA for the treatment of fecal incontinence and is currently available to patients at the Huntington Hospital. The pelvic floor research program is intimately related to our clinical efforts in the multidisciplinary treatment of pelvic floor disorders at the Huntington Hospital.
Patient Safety and Quality in Colorectal Surgery
This program focuses upon improving outcomes in colorectal surgery patients. Our goal is not only to track the clinical outcomes of patients with colorectal disorders treated at the Huntington Hospital, but to utilize validated outcomes based databases towards understanding risk and improving care for patients undergoing surgery for colorectal diseases.
Chung DC. The genetic basis of colorectal cancer: insights into critical pathways of tumorigenesis. Gastroenterology. 2000 Sep;119(3):854-65.
Toyota M, Ahuja N, Ohe-Toyota M, Herman JG, Baylin SB, Issa JP. CpG island methylator phenotype in colorectal cancer. Proc Natl Acad Sci 1999;96(15):8681-6.
Wexner SD, Coller JA, Devroede G, Hull T, McCallum R, Chan M, Ayscue JM, Shobeiri AS, Margolin D, England M, Kaufman H, Snape WJ, Mutlu E, Chua H, Pettit P, Nagle D, Madoff RD, Lerew DR, Mellgren A. Sacral nerve stimulation for fecal incontinence: Results of a 120-patient prospective multi-center study. Ann Surg. 2010; 251:441-449.
Research in Progress
- Evaluation of the role dynamic MR imaging in the management of pelvic floor disorders
- Prospective RCT of the use of sacral nerve stimulation in the treatment of fecal incontinence
- Prospective evaluations of epigenetic profiles in colon mucosa in patients with polyps, obese individuals
- Prospective evaluations of epigenetic profiles in serum and plasma or patients with and without colorectal neoplasia
- Safety and quality process implementation in colorectal and pelvic floor surgery
- The use of anastomotic buttresses in colorectal surgery
Major Areas of Research Interest
- Diagnosis and management of pelvic floor disorders
- Advanced treatments for fecal incontinence
- Multimodality treatment of rectal cancer, other pelvic malignancies
- Adhesion prevention following colorectal surgery
- The effects of morbid obesity on pelvic floor function
- The effects of morbid obesity on colon cancer risk
- Epigenetic markers in colorectal cancer
- Anastomotic buttressing in colorectal surgery
- Safety and quality processes in general, colorectal, and pelvic floor surgery
Huntington Hospital General Surgery Residency Program
- Lectures on colorectal diseases, pelvic floor disorders, patient safety and quality 2006-present
- Daily informal teaching of residents, fellows, and medical students in operating room, clinic, endoscopy suite, 2004-present
- Full-time teaching faculty, 2009-present
- Curriculum committee, 2009-present
- Advisor to categorical residents, 2009-present
Specific Administrative Responsibilities
- Medical Director, Cancer Services, Huntington Hospital 2007-present
- Chair, Cancer Committee, Huntington Hospital, 2007-present
- Surgical Quality Committee, Huntington Hospital, 2008-present
- Value Analysis Committee, Huntington Hospital, 2009-present
- Board of Directors, Southern California Chapter of American College of Surgeons, 2006-present
- Governor at large, American College of Surgeons
- Top Docs in San Gabriel Valley, Pasadena Magazine 2008 to 2011
- Southern California Super Doctor 2012
- HMH Radiation Oncology Dept
100 W. California Blvd.
Pasadena CA 91105
- www. hmri.org or http://howardkaufmanmd.com/
- Office: 626.397.5896